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information about me with the Pfizer Patient Assistance Program, Pfizer Inc, and the Pfizer Patient Assistance Foundation Inc. Signature of Patient X Date: (Parent or guardian, if under 18 years of age) 1 2 3 The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance FoundationTM. • Pfizer reserves the right to change or cancel the Pfizer Patient Assistance Program for Prevnar 13, or terminate my enrollment, at any time. There are currently multiple Pfizer original brand medications included in the Pfizer Originals Program. This information—including product information—is intended only for residents of the United States. The Pfizer Patient Assistance Foundation is a separate legal entity from Pfizer Inc. with distinct legal restrictions. Box 6976, St. Louis, MO 3166-697 T: 77-744-5675 F: 00-708-343 www.PfizerRxPath.com Group B [1] Pfizer RxPathways™ Patient Assistance Program: Enrollment Form for Group B Medicines In 2019 alone, we helped more than 214,000 patients gain access to their medicines.To learn more about Pfizer assistance options, eligibility requirements, and terms and conditions that apply, visit We realize times are challenging right now, and we want to help make things a little simpler when it comes to your Pfizer medicines. Today, Pfizer RxPathwaysIn the last 5 years (2015-2019), Pfizer has helped more than 1.2 million U.S. patients receive over 8 million Pfizer prescriptions for free or at a savings. Please speak to your health care provider about Pfizer’s assistance programs.Payment Assistance ProgramAdditionally, Canadians may consult www.pfizeroriginals.ca to learn more about our payment

Learn more about how we innovate to bring therapies to patients that significantly improve their lives.Research and development are at the heart of fulfilling Pfizer's purpose as we work to translate advanced science and technologies into the therapies that matter most.Find out about our diversified health care portfolio which includes some of the world’s best-known prescription medicines and vaccines.See how we support the people in the communities where we work and live through our community investment partnerships.

For more than 30 years, we’ve helped U.S. patients in need get access to their Pfizer medicines. Please speak to your health care provider about Pfizer’s assistance programs.If you prefer to stay on the Pfizer original brand medication you can continue to do so even after a generic becomes available.

Today, Pfizer RxPathways ® connects eligible U.S. patients to a range of Pfizer assistance programs that provide insurance support, co-pay help, and medicines for free or at a savings..

When a patient cannot afford their out-of-pocket costs for medicines despite their insurance coverage, for some medicines Pfizer offers assistance programs. This card can be used with or without your public or private insurance. Visit PfizerRxPathways.com for more info.Copyright © 2002-2020 Pfizer Inc. All rights reserved.

• Any vaccine supplied by the Pfizer Patient Assistance Program shall not be sold, traded, bartered, or transferred. Pfizer RxPathways P.O.

Provides free Pfizer medicines to eligible patients through their doctor’s office or at home. Pfizer Patient Assistance Program.

Sorry, you need to enable JavaScript to visit this website. Please check the appropriate Pfizer product (For full Prescribing Information, go to www.pfizer.com) The Pfizer Patient Assistance Program is a joint program of Pfizer Inc. and the Pfizer Patient Assistance FoundationTM. With the Pfizer Originals Program, you can save on certain Pfizer original brand medications with the Pfizer Originals savings card. The information is intended only for residents of Canada.

Card coverage may vary based on patient plan. To qualify, patients must: Have a valid prescription for the Pfizer medicine for which they are seeking assistance; Have no prescription coverage, or not enough coverage, to pay for their Pfizer medicine Enable JavaScript to visit this website.

Copyright © Pfizer Canada 2020 With variable salt sensitiv- ity (fig, this may be given orally or intravenously. For more than 30 years, we’ve helped U.S. patients in need get access to their Pfizer medicines. Patient Assistance Programs Pfizer RxPathways ® may be able to help.

Pfizer PAP Connect is a new tool that provides patients and their healthcare providers with online access to the Pfizer Patient Assistance Program, enabling them to place medicine orders, track shipments, and manage their enrollment for certain primary care medicines in real time, at any time.

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